Provider Demographics
NPI:1386906683
Name:CASSIDY, MAUREEN TERESA (MS ED)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:TERESA
Last Name:CASSIDY
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1385 ROUTE 376
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-6130
Mailing Address - Country:US
Mailing Address - Phone:845-849-1290
Mailing Address - Fax:845-849-1290
Practice Address - Street 1:1385 ROUTE 376
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-6130
Practice Address - Country:US
Practice Address - Phone:845-849-1290
Practice Address - Fax:845-849-1290
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist